Prevention Of Non-communicable Diseases Research Articles

Prevalence of non-communicable disease risk factors among nursing staff in a low and middle-income country: A cross-sectional digital survey-based study.

To assess the prevalence of non-communicable disease risk factors among the nursing staff and educate them on prevention. Nursing staff is integral to the Indian community healthcare systems. Recent studies report a high prevalence of non-communicable diseases in Indian nursing staff. Therefore, data on the prevalence of non-communicable disease risk factors among nursing staff are crucial for education on prevention. A cross-sectional digital survey-based study. We invited 4435 nursing staff to attend our online survey. We used a customized questionnaire for data collection, including a digitized version of the Community-Based Assessment Checklist form. A score of >4 was considered high risk and warranted screening. Among 682 nursing staff who attended, 70% had never undergone screening for non-communicable diseases. The prevalence of non-communicable disease risk factors was significantly higher in male nursing staff. In addition, logistic regression analysis showed that age, tobacco and alcohol use, increased waist circumference, physical inactivity and family history of non-communicable diseases were significant risk factors among nursing staff. The study findings suggest that the nursing staff have suboptimal self-health concerns on non-communicable diseases. This situation warrants continued medical education, awareness campaigns on adopting a healthy lifestyle and health promotion.

Unveiling non-communicable disease trends among Indian states: predicting health outcomes with socioeconomic and demographic factors

PurposeThe present study examines the fluctuations in Socioeconomic and demographic (SED) factors and the prevalence of Non-Communicable Diseases (NCDs) across clusters of states in India. Further, it attempts to analyze the extent to which the SED determinants can serve as predictive indicators for the prevalence of NCDs.Design/methodology/approachThe study uses three rounds of unit-level National Sample Survey self-reported morbidity data for the analysis. A machine learning model was constructed to predict the prevalence of NCDs based on SED characteristics. In addition, probit regression was adopted to identify the relevant SED variables across the cluster of states that significantly impact disease prevalence.FindingsOverall, the study finds that the disease prevalence can be reasonably predicted with a given set of SED characteristics. Also, it highlights age as the most important factor across a cluster of states in understanding the distribution of disease prevalence, followed by income, education, and marital status. Understanding these variations is essential for policymakers and public health officials to develop targeted strategies that address each state’s unique challenges and opportunities.Originality/valueThe study complements the existing literature on the interplay of SEDs with the prevalence of NCDs across diverse state-level dynamics. Its predictive analysis of NCD distribution through SED factors adds valuable depth to our understanding, making a notable contribution to the field.

Research outcomes informing the selection of public health interventions and strategies to implement them: A cross-sectional survey of Australian policy-maker and practitioner preferences

BackgroundA key role of public health policy-makers and practitioners is to ensure beneficial interventions are implemented effectively enough to yield improvements in public health. The use of evidence to guide public health decision-making to achieve this is recommended. However, few studies have examined the relative value, as reported by policy-makers and practitioners, of different broad research outcomes (that is, measures of cost, acceptability, and effectiveness). To guide the conduct of research and better inform public health policy and practice, this study aimed at describing the research outcomes that Australian policy-makers and practitioners consider important for their decision-making when selecting: (a) public health interventions; (b) strategies to support their implementation; and (c) to assess the differences in research outcome preferences between policy-makers and practitioners.MethodAn online value-weighting survey was conducted with Australian public health policy-makers and practitioners working in the field of non-communicable disease prevention. Participants were presented with a list of research outcomes and were asked to select up to five they considered most critical to their decision-making. They then allocated 100 points across these – allocating more points to outcomes perceived as more important. Outcome lists were derived from a review and consolidation of evaluation and outcome frameworks in the fields of public health knowledge translation and implementation. We used descriptive statistics to report relative preferences overall and for policy-makers and practitioners separately.ResultsOf the 186 participants; 90 primarily identified as policy-makers and 96 as public health prevention practitioners. Overall, research outcomes of effectiveness, equity, feasibility, and sustainability were identified as the four most important outcomes when considering either interventions or strategies to implement them. Scores were similar for most outcomes between policy-makers and practitioners.ConclusionFor Australian policy-makers and practitioners working in the field of non-communicable disease prevention, outcomes related to effectiveness, equity, feasibility, and sustainability appear particularly important to their decisions about the interventions they select and the strategies they employ to implement them. The findings suggest researchers should seek to meet these information needs and prioritize the inclusion of such outcomes in their research and dissemination activities. The extent to which these outcomes are critical to informing the decision of policy-makers and practitioners working in other jurisdictions or contexts warrants further investigation.

CONTEMPORARY STATE OF DIAGNOSIS AND TREATMENT OF BRONCHIAL ASTHMA AMONG CHILDREN

This paper provides a brief overview of the current state of diagnosis and treatment of bronchial asthma among the pediatric population, given the increasing incidence worldwide. Materials and methods: Wiley, PubMed, Web of Science, Scopus databases and health compilations of the Republic of Kazakhstan over a five-year period (2018-2023) were used for this review. Currently, the WHO European Region is facing a significant threat from the growing incidence of preventable noncommunicable diseases (NCDs), among which chronic respiratory diseases are highlighted. These diseases not only reduce the quality of life of individuals but also cause substantial economic damage to families, communities, and countries as a whole, which underscores the relevance of our chosen topic. According to expert estimates, there are more than 350 million people worldwide with bronchial asthma, with about 5-10% of cases being among the pediatric population. In Kazakhstan, there is a steady trend of increasing incidence worldwide.

Prevalence of hypertension and diabetes mellitus in Peruvian patients with chronic kidney disease: a systematic review and meta-analysis

BackgroundChronic Kidney Disease (CKD) represents a major challenge for public health, with hypertension and diabetes being the main causes of its occurrence. Therefore, this study aims to determine the prevalence of hypertension (HTN) and diabetes mellitus (DM) in Peruvian patients with CKD.MethodsA systematic search for studies about CKD in Peru was carried out in PubMed, Scopus, Embase, Web of Science, ScienceDirect, Google Scholar, Virtual Health Library (VHL), and Scielo from 2011 to December 2023. The protocol of this research was registered in the international registry of systematic reviews, the Prospective International Registry of Systematic Reviews (PROSPERO), with registration number CRD42023425118. Study selection, quality assessment, and data extraction were performed independently by two authors. Study quality was assessed using the Joanna Briggs Institute Statistical Meta-Analysis Assessment and Review Instrument. A random-effects model with inverse variance weighting was used to estimate the combined prevalence of HTN and DM in Peruvian patients with CKD. To analyze data heterogeneity, the I2 statistical test was used. Statistical analysis was performed with R version 4.2.3.ResultsA total of 1425 studies were retrieved, of which 23 were included in the final meta-analysis. A total of 43,321 patients with CKD were evaluated, of whom 52.22% were male and 47.78% were female. The combined prevalence of HTN in Peruvian patients with CKD was 38% (95% CI: 30–46%; 41,131 participants; 21 studies, I2 = 99%, p = 0), while the combined prevalence of DM in Peruvian patients with CKD was 33% (95% CI: 26–40%; 43,321 participants; 23 studies, I2 = 99%, p = 0).ConclusionApproximately one-third of Peruvian patients with CKD have HTN and DM. These findings highlight the importance of implementing prevention and control measures for these chronic noncommunicable diseases in the Peruvian population, such as promoting healthy lifestyles, encouraging early detection and proper management of hypertension and diabetes, and improving access to medical care and health services.

A proposed dietary policy package for the health sector in Iran

BackgroundInsufficient physical inactivity and an unhealthy diet are significant health risk factors globally. Dietary risk factors were responsible for approximately 16.5% of all deaths in Iran in 2019. This paper aimed to propose a dietary policy package for the health sector to reduce the risk of an unhealthy diet, which might effectively help prevent and control non-communicable diseases (NCDs) in Iran.MethodsIn this qualitative study, we conducted semi-structured, face-to-face, and in-depth interviews with 30 purposefully selected experts, including policymakers, high-level managers, and relevant stakeholders, during 2018–2019 in Iran. All interviews were digitally recorded, transcribed verbatim, and thematically analyzed, facilitated by MAXQDA 11 software.ResultsWe developed several dietary recommendations for different stakeholders. These include traffic light labeling reforms, i.e., the need to make the signs large and readable enough through utilizing advanced technology, cooperation with other sectors, promoting healthy symbols and supporting food products with them, food basket reforms, updating dietary standards, adopting appropriate mechanisms to report violations of harmful products laws, scaling up mechanisms to monitor restaurants and processed foods, and creating an environment for ranking restaurants and other relevant places to support a healthy diet, for instance through tax exemption, extra subsidies for healthy products, Non-Government Organizations (NGOs) alliances, and using influential figures.ConclusionIran’s health sector has developed a practical roadmap for the prevention and control of NCDs through promoting healthy nutrition. In line with the sustainable development goal (SDG) 3.4 pathway to reduce premature mortality due to NCDs by 30% by 2030 in Iran, we advocate for the Ministry of Health and Medical Education (MoHME) to adopt appropriate evidence-informed interventions for improving public health literacy and reducing consumption of unhealthy food.

Prevalence of Noncommunicable Disease (NCDs) risk factors in Tamil Nadu: Tamil Nadu STEPS Survey (TN STEPS), 2020.

Noncommunicable diseases (NCDs) account for nearly 75% of all deaths in Tamil Nadu. The government of Tamil Nadu has initiated several strategies to control NCDs under the Tamil Nadu Health Systems Reform Program (TNHSRP). We aimed to estimate the prevalence of NCD risk factors and determine the predictors of diabetes and hypertension, which will be helpful for planning and serve as a baseline for evaluating the impact of interventions. A state-wide representative cross-sectional study was conducted among 18-69-year-old adults in Tamil Nadu in 2020. The study used a multi-stage sampling method to select the calculated sample size of 5780. We adapted the study tools based on WHO's STEPS surveillance methodology. We collected information about sociodemographic factors, NCD risk factors and measured blood pressure and fasting capillary blood glucose. The predictors of diabetes and hypertension were calculated using generalised linear models with 95% confidence intervals (95% CI). Due to the COVID-19 pandemic lockdown, we could cover 68% (n = 3800) of the intended sample size. Among the eligible individuals surveyed (n = 4128), we had a response rate of 92%. The mean age of the study participants was 42.8 years, and 51% were women. Current tobacco use was prevalent in 40% (95% CI: 33.7-40.0) of men and 7.9% (95% CI: 6.4-9.8) of women. Current consumption of alcohol was prevalent among 39.1% (95% CI: 36.4-42.0) of men. Nearly 28.5% (95% CI: 26.7-30.4) of the study participants were overweight, and 11.4% (95% CI: 10.1-12.7) were obese. The prevalence of hypertension was 33.9% (95% CI: 32.0-35.8), and that of diabetes was 17.6% (95% CI: 16.1-19.2). Older age, men, and obesity were independently associated with diabetes and hypertension. The burden of NCD risk factors like tobacco use, and alcohol use were high among men in the state of Tamil Nadu. The prevalence of other risk factors like physical inactivity, raised blood pressure and raised blood glucose were also high in the state. The state should further emphasise measures that reduce the burden of NCD risk factors. Policy-based and health system-based interventions to control NCDs must be a high priority for the state.

Sources of Carotenoids in Amazonian Fruits

Epidemiological studies have shown that a diet rich in bioactive components significantly reduces cardiovascular disease incidence and mortality. In this sense, there is a need for meta-analytical research that confirms this phenomenon and increases specific knowledge about certain bioactive compounds such as carotenoids. Thus, this systematic review and meta-analysis aim to disseminate knowledge about the sources of carotenoids in fruit consumed in the north of Brazil which are outside the Brazilian trade balance. A systematic review and a meta-analysis following the PRISMA guidelines were conducted based on a random effects synthesis of multivariable-adjusted relative risks (RRs). Searches of seven sources were carried out, including PubMed, Science Direct from Elsevier, Web of Science, Scielo, Eric Research and Google Scholar databases. The systematic review was guided by a systematic review protocol based on the POT strategy (population, outcome and type of study) adapted for use in this research. Mendeley was a resource used to organize and manage references and exclude duplicates of studies selected for review. In this review, we present the potential bioactive compounds concentrated in little-known fruit species from the Amazon and their benefits. Consuming fruits that are rich in notable constituents such as carotenoids is important for the prevention of chronic non-communicable diseases through anti-inflammatory and anticoagulant properties, as well as antivirals, immunomodulators and antioxidants agents that directly affect the immune response.

Promotive and preventive education of non-communicable diseases for the community

Non-communicable diseases such as diabetes, cancer, and heart disease are global health challenges that require a holistic approach to their prevention and management. Promotive and preventive education has been recognized as an effective strategy for increasing public health awareness and reducing the incidence of non-communicable diseases. This service activity can improve health awareness in the community, primarily related to promotive and preventive education. Measures such as education campaigns, education in schools, collaboration with communities, and the use of technology have been discussed as effective strategies for achieving this goal. In conclusion, the joint efforts of different parties and diverse methods are crucial to creating an environment that supports high health awareness. Implementing the right strategy is expected to increase public understanding of the importance of a healthy lifestyle and the prevention of non-communicable diseases and produce positive behavioral change in the long term. Joint efforts from different sectors and diverse methods can help increase health awareness in the community, realize a healthy lifestyle, and reduce the risk of non-communicable diseases significantly. Health awareness includes an understanding of a healthy lifestyle and the ability to implement that knowledge in everyday life.

More People, More Active, More Often for Heart Health - Taking Action on Physical Activity.

Physical inactivity is a leading contributor to increased cardiovascular morbidity and mortality. Almost 500 million new cases of preventable noncommunicable diseases (NCDs) will occur globally between 2020 and 2030 due to physical inactivity, costing just over US$300 billion, or around US$ 27 billion annually (WHO 2022). Active adults can achieve a reduction of up to 35% in risk of death from cardiovascular disease. Physical activity also helps in moderating cardiovascular disease risk factors such as high blood pressure, unhealthy weight and type 2 diabetes. For people with cardiovascular disease, hypertension, type 2 diabetes and many cancers, physical activity is an established and evidence-based part of treatment and management. For children and young people, physical activity affords important health benefits. Physical activity can also achieve important cross-sector goals. Increased walking and cycling can reduce journeys by vehicles, air pollution, and traffic congestion and contribute to increased safety and liveability in cities.

Spatial distribution of non-communicable diseases; a case of Ischaemic Heart Diseases, Cancer and Diabetes in Sri Lanka

The abstract provides a comprehensive overview of the global prevalence of non-communicable diseases (NCDs) and their impact on public health, emphasizing their leading role in morbidity and mortality worldwide. It highlights the specific burden of Ischaemic heart diseases, cancers, and diabetes, with a significant portion of premature deaths occurring in low- and middle-income countries. Transitioning to Sri Lanka, the abstract underscores the country's shift towards NCDs as the primary health concern, attributing over 80% of premature deaths to these diseases. The narrative emphasizes the influence of rapid lifestyle changes and socio-economic development on the rise of NCDs in Sri Lanka and emphasizes the urgent need for comprehensive research to understand trends, patterns, and contributing factors for effective preventive measures.

The prevalence and pattern of comorbid long-term conditions with low back pain and osteoarthritis in low- and middle-income countries: a systematic review and meta-analysis

ABSTRACT Chronic musculoskeletal (MSK) pain, specifically low back pain (LBP) and osteoarthritis (OA), are a major cause of global disability, reduced quality of life and high socioeconomic burden. Research in high income countries suggests MSK pain is often comorbid with other long-term conditions / non-communicable diseases (NCDs) including diabetes, hypertension, and cardiovascular disease. However, the epidemiology of comorbid NCDs and MSK pain in low- and middle-income countries (LMICs) is unclear. This systematic review aims to describe the prevalence and pattern of comorbid NCDs in adults with MSK pain in LMICs. Nine databases were searched for epidemiological studies in LMICs (World Bank categories). Paired researchers independently identified studies, extracted data, and completed critical appraisal using Hoy risk of bias tool. Random-effect meta-analysis was used to estimate prevalence of NCDs comorbid with MSK pain. From 2112 citations; 14 studies (n=6093 adults with MSK pain, mean age=46.9years) were included. Overall prevalence of MSK pain with comorbid NCDs was 46.1% (95%CI 32.3 - 59.9). Systemic hypertension had the highest comorbid prevalence with MSK pain (42.6%, 95%CI 25.6-59.6), followed by diabetes (26.7%, 95%CI 16.1-37.3) and mental health conditions (anxiety/depression; 24.9% 95%CI 11.5-38.4). A high proportion of patients with MSK pain in LMICs experience comorbid NCDs. Variable data/population samples, and under-reporting limit accurate capture of prevalence estimates. Understanding the true burden of MSK pain (specifically lower back pain and hip/knee osteoarthritis) and comorbid NCDs is critical to informing effective treatment strategies. The health systems implications of these findings are imperative towards person-centred care, organisation of care and efficient resource utilisation in LMICs.

IT’S NEVER TOO LATE TO START: A CASE FOR PREVENTATIVE OUTPATIENT GERIATRIC SERVICES

INTRODUCTION & AIMS The population is ageing and the chronic disease burden growing, seeing more older adults present to hospital with preventable non-communicable diseases. Multidisciplinary outpatient teams are well placed to manage modifiable risk factors to prevent disease progression and hospitalisations. A preventative service was launched at Concord Hospital integrating geriatrician, exercise physiologist and dietitian care to optimise the physical and mental health of older adults with chronic disease and frailty. This evaluation aims to determine the success of service implementation and feasibility of the model. METHODS Between November 2022 and June 2023, 59 patients (mean age 80.2 years (SD 6.2), 47.5% female) completed 12-weeks of concurrent exercise and diet interventions with medical oversight. Patients were assessed pre- and post-interventions. Exercise was individualised and multimodal, performed twice weekly in a supervised group. Diet was individualised with a protein supplement prescribed as appropriate. The outcomes measured were Fried Frailty Phenotype (FFP), leg strength (one repetition maximum leg press), Short Physical Performance Battery (SPPB), Geriatric Depression Scale Short Form (GDS), and Mini Nutritional Assessment Long Form (MNA). Service activity was measured monthly via rate of referral and occasions of service (OOS). Data were analysed using JASP (v.0.18.1). RESULTS Monthly rate of referral and OOS increased from 18 to 51 patients and 49 to 479 occasions respectively, indicating service demand. After 12-weeks there were significant improvements in FFP (mean difference [95%CI] -0.4 [-0.7, -0.2] points), leg strength (34.0 [27.1, 40.8] kilograms), SPPB (1.1 [0.8, 1.5] points), GDS (-1.4 [-2.2, -0.6] points) and MNA (2.6 [1.6, 3.5] points), with no effect of sex observed. CONCLUSION Initial implementation of a preventative outpatient geriatric service was successful with increasing service demand and significant physical and mental health improvements. The service model is feasible; however, further evaluation is required to determine outcomes after continued service provision.

Process evaluation of a complex, multilevel, multicomponent scheme for the prevention and control of non-communicable diseases in Tamil Nadu, India: A mixed-methods protocol

BackgroundNon-communicable diseases (NCDs) are the leading cause of morbidity and mortality in India, necessitating development of multilevel and multicomponent interventions. Makkalai Thedi Maruthuvam (MTM) is a complex multilevel, multicomponent intervention developed and implemented by the south Indian State of Tamil Nadu. The scheme aims to deliver services for preventing and controlling diabetes, and hypertension at doorstep. This paper describes the protocol for planning and conducting the process evaluation of the MTM scheme. Methods and analysisThe process evaluation uses mixed methods (secondary data analysis, key informant interviews, in-depth interviews, conceptual content analysis of documents, facility-based survey and non-participant observation) to evaluate the implementation of the MTM scheme. The broad evaluation questions addressed the fidelity, contexts, mechanisms of impact and challenges encountered by the scheme using the Consolidated Framework for Implementation Research (CFIR) framework. The specific evaluation questions addressed selected inputs and processes identified as critical to implementation by the stakeholders. The CFIR framework will guide the thematic analysis of the qualitative interviews to explore the adaptations and deviations introduced during implementation in various contexts. The quantitative data on the indicators developed for the specific evaluation questions will be cleaned and descriptively analysed.

Perspectives for the Prevention of Noncommunicable Diseases in Tanzania: Is Knowledge Translated into Practice?

In Tanzania, where over a third of the society is impoverished, the burden of NCDs which account for about two-fifths of all disability-adjusted life years (DALYs) and one-third of premature deaths has doubled in the past two decades. However, notwithstanding a wider realization of the escalating burden of NCDs across Tanzania, the link between NCD awareness and lifestyle practices at the population level is not well characterized. We aimed to establish the gap between NCD knowledge and healthy behaviors. This multi-regional community-based cross-sectional study was conducted in 5 regions of Tanzania between September 2022 and June 2023. A 22-item standardized tool evaluating various NCD risk behaviors was used in knowledge assessment and a cut-off of ≥70% was used to denote good knowledge. Bivariate analyses were performed to compare knowledge of NCD risk factors across various NCD risk subgroups. All tests were two tailed, and the significance was set at p<0.05. A total of 5121 individuals were consecutively enrolled. The mean age was 47.2 years and females comprised over three-fifths (60.8%) of the participants. With regard to behavioral NCD risks, physical inactivity, unhealthy diet, smoking and alcohol consumption were present in 79.0%, 70.2%, 2.1% and 17.6% of participants, respectively. Moreover, biological risk factors, ie, excess body weight, hypertension, and diabetes were present in 68.4%, 55.8% and 13.0% of participants, respectively. The mean knowledge score was 77.1% and 70.3% of participants demonstrated good knowledge of NCD risk factors. Except for smoking, individuals who showed awareness of various NCD risk factors were found to have significant rates of risky behaviors. Despite sufficient NCD risk knowledge, incongruent lifestyle practices persist, highlighting a crucial concern. This suggests that awareness of NCDs and their risks may influence motivation for change but may not necessarily result in lifestyle modification.

Physical Activity Policies at National and Subnational Levels: A Study in Colombia, Costa Rica, Ecuador, and Mexico.

National physical activity (PA) policy processes are only beginning to be studied in Latin America, and little attention has focused at the subnational level. This study examined national-subnational relations in the policy process (agenda setting, policy formulation, adoption, implementation, and evaluation) in selected Latin American countries. The Global Observatory for Physical Activity's (GoPA!) INTEGRATE-PA-Pol tool was applied in Colombia, Costa Rica, Ecuador, and Mexico. Data were collected in matched pairs of the capital plus one noncapital city among national and subnational policymakers (n = 27), previously identified by the GoPA! Country Contacts. PA policy development and implementation were assessed using descriptive statistics. Twenty-three (response rate = 85.2%) informants provided data, mainly from the health sector (52.2%), followed by the sport (26.1%), transport (13.0%), and education (8.7%) sectors. Most informants reported that their countries had a current PA policy embedded within noncommunicable diseases prevention plans (46.2%), other plans (46.2%), or obesity prevention/management/control plans (7.7%). Respondents at the subnational level rated PA promotion as central (64.3%), while the national-level role was important but not central (75.0%). National and subnational policymakers indicated low-to-little involvement in the other level's PA policy processes across the 5 policy stages. This study demonstrated that collecting national and subnational PA policy data across countries with the active collaboration of the GoPA! network was feasible. We also successfully identified governmental interactions throughout the PA policy process, suggesting suboptimal engagement between national and subnational levels.

The role of diabetes in low back pain compared to non-diabetics

Background: Type 2 diabetes is a prevalent non-communicable disease, affecting significant proportion of the global population, with an estimated 382 million individuals affected. There exists a correlation among diabetes and low back pain. The objective of this investigation was to examine the potential association linking diabetes and low back pain by utilising the Oswestry disability Index as a gauge of the intensity of persistent lower back pain. Methods: The study was conducted by cross sectional method in which 200 patients with low back pain were included from period of October 2020 to September 2022. Oswestry disability index questionnaire was used for the intensity of lower back pain. Statistical package for the social sciences was used for data analysis. Results: In this study, out of 200 patients, 59 (29.5%) had diabetes and 141 (70.5%) were without diabetes, with a average age of 53.61±15.07 years. Overall, according to gender, patients were equally distributed, while female and male predominance was seen in diabetics and non-diabetics, respectively. Conclusions: The distribution of patients as per gender and ODI score did not differ, although more diabetics had a significantly higher ODI score than non-diabetics. A significant increase in blood glucose, HbA1c, microalbuminuria, and ODI score was noted in diabetics compared with non-diabetics, with significant positive associations of ODI with age, blood glucose, and HbA1c. The increased levels of the diabetic profile parameters and their association with the ODI indicate the possible role of diabetes with low back pain.

Assessing nutrition literacy and nutrition counseling proficiency following an interdisciplinary culinary medicine elective.

Culinary medicine (CM) is a growing field of education that aims to bridge the gap between the clinical need for nutritional counseling and the lack of education on the topic. Healthcare professionals can aid in nutrition-related noncommunicable disease (NCD) prevention by improving a patient's dietary behavior. However, the presence of nutrition education in healthcare curricula is lacking. Early evidence indicates that CM could address this gap. The objectives of this study are to determine ifthe provision of an interdisciplinary CM elective will improve student knowledge and confidence with counseling on nutrition and culinary principles, and to improve personal dietary habits of students. This was a one-group pretest-posttest quasi-experimental design. First- and second-year osteopathic medical students (OMS) and nurse practitioner students were recruited to participate in a CM elective via email. Participants were excluded if they were not in good academic standing at their respective institutions. Twelve individuals (n=8 medical; n=4 nursing) were enrolled in the course. Participants completed pre- and postcourse surveys to determine changes in nutrition literacy (Nutrition Literacy Assessment Instrument [NLit42]), nutrition counseling proficiency (Nutrition Survey for Family Practitioners), and dietary quality (Automated Self-Administered 24-h dietary assessment tool; ASA24®). A two-sided, paired t test was conducted to determine changes in outcome variables. All 12 participants completed the precourse assessments, and 8 participants completed the postcourse assessments. Culinary activity attendance was 94.5 %. Participants exhibited a statistically significant increase in their overall nutrition literacy scores after completing the CM elective (p=0.006). Literacy subcategories indicated that the improvement came from the participant's ability to understand household measurements (p=0.005) better. Increases in self-reported proficiency were observed for participants' confidence to counsel on nutrition and prevention/wellness (p=0.02) and macronutrients in health and food safety (p=0.01). No statistically significant changes in the personal dietary pattern or quality were observed. The interdisciplinary CM elective improved nutrition literacy and some aspects of counseling proficiency. Although small shifts in dietary variables were observed, the elective did not statistically improve participants' dietary pattern. However, some changes that were observed may lead to clinically relevant outcomes if maintained long-term. These findings are encouraging. Implementing CM as an educational tool could improve healthcare practitioners' ability to understand and counsel patients on nutrition to prevent the nutrition-related NCDs.

Impact of medical bloggers’ activities on the prevention of disease risk, public, population and individual health: the opinion of social media users

Due to the high information and communication importance and potential of the medical blogosphere in the formation of health literacy of the population, there is the increased need to study the opinions of Russian social media users on the impact of the content of medical blogs on personal and public health. Aim of the study was to find out the opinion of social media users on the extent to which the activities of bloggers specializing in public health and health care topics influence the prevention of major non-communicable and infectious diseases, public and personal health, within the changing boundaries of medical knowledge broadcasting (using sociological methods). Material and methods. The authors conducted a quantitative sociological survey of 178 respondents - users of social media: 55 (30.9 %) women and 123 (69.1 %) men about visiting blogs specializing in public health and healthcare. The collection of information was carried out by e-mailing a questionnaire developed by the authors, and analyzed the answers to questions from active blog users through a Google form in April – May 2023. Results. The study results of the impact of bloggers’ activities on personal and public health, including those related to the quality of medical information disseminated in social media, are described. Respondents believe that medical bloggers have a greater impact on public health than personal health. At the same time, according to the respondents, the spheres of influence in the field of public health do not coincide with the spheres of influence in the field of personal health. Thus, 74.7 % of respondents believe that medical bloggers have an impact on maintaining a healthy lifestyle of the population, prevention (61.8 % of all respondents think so) and treatment of infectious diseases (61.2 %). The requirements for the quality of information provided by bloggers are considered. Based on the analysis of Russian and foreign scientific literature, the authors developed a graphical diagram of the effect of dissemination through the blogosphere of information in the field of health care and disease prevention. Conclusions. The content published on medical blogs affects the health literacy of the population. That is why, medical blogs can be seen as a social determinant of health, because health blogs can be the key to the success of disease prevention and control efforts for public health maintaining. For organizing a communication intervention of medical personnel in social media to inform the population about methods for preventing the risk of developing major non-communicable and infectious diseases and increasing the level of health literacy of the population, medical blogs can and should be used to inform and educate patients as part of general or targeted multimodal educational practices or as a means of delivering electronic content. The risks of publishing inaccurate information in the blogosphere must be considered, whereby patients can easily become misinformed, which can have serious consequences for their health, and even increase their risk of mortality. To make the best use of the blogosphere, it is necessary to solve the problems of content accuracy and increase the level of professionalism of bloggers who write on medical topics. They need to be professionally trained to work for health, contributing to the prevention of the risk of developing major non-communicable and communicable diseases, improving the health of the population through education, and raising the level of health literacy. It makes sense to assess the success of the communicative intervention of doctors in social media and their management of the training of medical bloggers as a personnel determinant of public health, since it will depend on the personnel potential of the healthcare sector.

The role of community pharmacists and pharmacies in physical activity promotion: an interdisciplinary e-Delphi study.

Physical activity has a key role in the prevention and control of noncommunicable diseases. Community pharmacists are an accessible source to provide brief advice to people on how to be more physically active. Nonetheless, there is a limited understanding of stakeholders' perspectives on their role in promoting physical activity, to inform policy and practice. The present study addresses this gap. To determine consensus from different health professionals on the role of pharmacists and pharmacies in brief physical activity counselling in Portugal. This cross-sectional study used a two-round e-Delphi panel. The questionnaire was organised into four domains of physical activity promotion and comprised 37 items. Interdisciplinary experts rated their level of agreement using a 5-point Likert scale. Consensus was set at the outset as 75% or more of participants scoring 4 or 5 (consensus "in") or 1 or 2 (consensus "out"). Forty-two health professionals involved in promoting physical activity in the ambulatory setting in Portugal were selected through purposive quota sampling. Eighteen out of 37 items were consensual in the first round and five more achieved consensus after the second round (62.2%). Physical activity promotion was seen as the role of all healthcare workforce and pharmacies were considered as suitable spaces for service provision, regardless of remuneration. This study endorses a set of roles for physical activity promotion in community pharmacy from an interdisciplinary perspective. Consensually established perspectives can inform policy making and practice, streamlining the coordination of pharmacies with the national health service.